Outcomes of Children With Firearm Injuries Admitted to the PICU in the United States*

Bagdure, Dayanand; Foster, Cortney; N, Garber; Holloway, Adrian; Day, Jenni; Lee, Jessica; Soto‐Campos, Gerardo; Brundage, Nancy; Bhutta, Adnan T.; Graciano, Ana Lía

doi:10.1097/pcc.0000000000002785

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…19 In the present study, the mortality rate was highest among those with self-directed firearm injuries than in the other groups, which is similar to the findings of earlier studies. [20][21][22] A continuous rise can be seen in cases of self-harm by firearms among children 20 , and previous studies have reported that firearm-related injuries contribute to the rate of disabilities among children, making gun violence an important public health issue. 7 Around half of all children hospitalized with firearm injuries are discharged with disabilities.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of firearm-related injuries in children in Turkey

Vatansever

Yılmaz

Nalbant³

et al. 2022

Turk J Pediatr

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Background. A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm injuries sustained by children in Turkey to date. Methods. This multicenter, retrospective, cohort study was conducted between 2010 and 2020 with the contributions of the PEDs, PICUs, intensive care units, and surgery departments of university hospitals and research hospitals. Results. A total of 508 children were admitted to hospital with firearm-related injuries in the research period, although the medical records of only 489 could be obtained. Of the total admissions to hospitals, 55.0% were identified as unintentional, 8.2% as homicide, 4.5% as self-harm, and 32.3% as undetermined. The Glasgow Coma Scale (GCS) and ventilation support were found to be the most significant predictors of mortality, while head/neck injury, length of stay (LOS) in the hospital and surgical interventions were found to be the most significant predictors of disability. The overall mortality of firearm-related injuries was 6.3%, and the mortality for children admitted to the PICU was 19.8%. The probability of disability was calculated as 96.0% for children hospitalized with firearm injuries for longer than 75 days. Conclusions. Head/neck injury, LOS in the hospital, and surgical interventions were found to be the most significant parameters for the prediction of disability. Hospitalization exceeding 6 days was found to be related to disability.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of firearm-related injuries in children in Turkey

Vatansever

Yılmaz

Nalbant³

et al. 2022

Turk J Pediatr

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“…Historically, GSWs constitute 10% (interquartile range [IQR], 8-16%) of pediatric trauma activations at our center annually, with an average of 13.8% over the past 5 years. Although a recently published study characterized PICU mortality among pediatric GSW patients, risk factors for admission remain unclear (10). The primary objective of this study was to characterize mortality, likelihood of PICU admission, and risk factors associated with PICU admission among children with GSWs in a single urban academic center with a disproportionately high volume of pediatric firearm injury.…”

mentioning

confidence: 99%

Mortality and PICU Hospitalization Among Pediatric Gunshot Wound Victims in Chicago

Rhine

Hegermiller

Kane

et al. 2022

Critical Care Explorations

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IMPORTANCE:Firearm injury accounts for significant morbidity with high mortality among children admitted to the PICU. Understanding risk factors for PICU admission is an important step toward developing prevention and intervention strategies to minimize the burden of pediatric gunshot wound (GSW) injury. OBJECTIVES:The primary objective of this study was to characterize outcomes and the likelihood of PICU admission among children with GSWs. DESIGN, SETTING, AND PARTICIPANTS:Retrospective cohort study of GSW patients 0-18 years old evaluated at the University of Chicago Comer Children's Hospital Pediatric Trauma Center from 2010 to 2017. MAIN OUTCOMES AND MEASURES:Demographic and injury severity measures were acquired from an institutional database. We describe mortality and hospitalization characteristics for the cohort. We used logistic regression models to test the association between PICU admission and patient characteristics. RESULTS:During the 8-year study period, 294 children experienced GSWs. We did not observe trends in overall mortality over time, but mortality for children with GSWs was higher than all-cause PICU mortality. Children 0-6 years old experienced longer hospitalizations compared with children 13-16 years old (5 vs 3 d; p = 0.04) and greater frequency of PICU admission (83.3% vs 52.9%; p = 0.001). Adjusting for severity of illness, children less than 7 years old were four-fold more likely to be admitted to the PICU than children 13-16 years old (aOR range, 3.9-4.6). CONCLUSIONS AND RELEVANCE:Despite declines in pediatric firearm mortality across the United States, mortality did not decrease over time in our cohort and was higher than all-cause PICU mortality. Younger children with GSWs experience longer hospitalizations and require PICU care more often than older children. Our findings suggest that the youngest victims of firearm-related injury may be particularly at-risk of the long-term sequelae of critical illness and injury.

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“…According to Bagdure et al (5), Black children are about 14% of the patient population, but they suffer 45% of critical firearm injuries and 30% of firearm deaths in the PICU. Although White children had a higher overall mortality, it is disproportionately low compared with population representation.…”

mentioning

confidence: 99%

“…These data again highlight violence and firearm injury as a health disparity, reflecting systemic racism and structural inequality experienced by Black youth. The analyses by Bagdure et al (5) emphasize the continued need for comprehensive, accessible, and highly detailed national datasets on fatal and nonfatal firearm injuries in order to fully understand the magnitude of this public health problem (7).…”

mentioning

confidence: 99%

“…In this issue of Pediatric Critical Care Medicine , Bagdure et al (5) provide a significant contribution to our knowledge of outcomes of children injured by firearms who were admitted to PICUs in the United States. The study by Bagdure et al (5) looked at data from 107 sites contributing to Virtual PICU Systems to evaluate mortality and functional status at discharge for surviving children using Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores. Rates of mortality from firearm injuries are five times that of all-cause PICU mortality, and risks are not the same for all children.…”

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confidence: 99%

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This Is Our Lane: The Role of Pediatric Intensivists in Firearm Violence and Injury Prevention*

Behrens

Hoops

2021

Pediatric Critical Care Medicine

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Outcomes of Children With Firearm Injuries Admitted to the PICU in the United States*

Abstract: Firearm-related injury is the second leading cause of injury and death for children 1-18 years old in United States. The objective of our study was to analyze the outcomes of children admitted to the PICU with firearm injuries. DESIGN: Retrospective study.

Cited by 8 publications

References 18 publications

Clinical characteristics of firearm-related injuries in children in Turkey

Clinical characteristics of firearm-related injuries in children in Turkey

Mortality and PICU Hospitalization Among Pediatric Gunshot Wound Victims in Chicago

This Is Our Lane: The Role of Pediatric Intensivists in Firearm Violence and Injury Prevention*

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